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General NPI Number Information
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NPI Number | 1295050748
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Entity Type | Individual
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Provider Name | SCOTT W. BERRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2010
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 100 EXCELA HEALTH DR STE 103
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City | LATROBE
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State | PA
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Zip | 15650-9001
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Country | US
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Telephone | 724-804-1780
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Fax | 724-804-1779
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Provider Business Mailing Address
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Address Line | 520 JEFFERSON AVE STE 400
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City | JEANNETTE
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State | PA
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Zip | 15644-2538
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Country | US
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Telephone | 724-689-1822
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Fax | 724-522-4002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD453322
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License Number State | PA
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